HTN drugs

Question 1

Clonidine

Answer 1

a2 agonist; also for ADHD and pain mgmt; stimulates a2 receptors centrally in brainstem (vasomotor ctr) –> decreased sympathetic outflow and peripheral resistance; sudden stoppage can lead to rebound HTN; CNS effects

Question 2

Methyldopa

Answer 2

a2 agonist; also for BP control during pregnancy; stimulates a2 receptors centrally in brainstem (vasomotor ctr) –> decreased sympathetic outflow and peripheral resistance; sudden stoppage –> rebound HTN; CNS effects

Question 3

Prazosin

Answer 3

a1 blocker; mainly for BPH; prevents activation of a1 receptors peripherally –> arteriole dilation; 1st dose orthostatic hypotension (give at night); reflex tachy (from hypotension); impotence/inhibition of ejaculation

Question 4

Carvedilol, Labetalol

Answer 4

Beta blockers; non-selectively block beta receptors on heart, kidneys, and periphery; boxed warning: ischemic heart disease, sudden stoppage –> risk for angina/MI; brady; exacerbation of HF; hypoglycemia

Question 5

Metoprolol, Succinate

Answer 5

Beta blockers; selectively block beta receptors on heart and kidneys; boxed warning: ischemic heart disease, sudden stoppage –> risk for angina/MI; brady; exacerbation of HF; hypoglycemia

Question 6

Lisinopril

Answer 6

ACE inhibitor; for ppl w/DM and CKD (protects kidneys); used post MI; drug:drug interactions: drugs that increase K, lithium, diuretics, NSAIDs/ASA, COX inhibitors; works on RAAS to decrease aldosterone (Na and H20 excreted, K retained); boxed warning: fetal harm; hyperkalemia; non-productive cough and angioedema

Question 7

Losartan

Answer 7

ARB; for ppl w/DM and CKD (protects kidneys); used post MI; drug:drug interactions: drugs that increase K, lithium, NSAIDs; works on RAAS to decrease aldosterone (Na and H20 excreted, K retained); boxed warning: fetal harm; hyperkalemia; less risk than ACE inhibitors for non-productive cough and angioedema

Question 8

Alikiren

Answer 8

Renin inhibitor; still new; drug:drug interactions: drugs that increase K, diuretics; works on RAAS to decrease aldosterone (Na and H20 excreted, K retained); boxed warning: fetal harm; hyperkalemia; non-productive cough and angioedema; SJS and TEN reported

Question 9

Nifedipine

Answer 9

Ca channel blocker; DHP: blocks Ca channels in vascular smooth muscle NOT myocardium –> dilation; peripheral edema; flushed skin; rebound tachy (can add on beta blocker to reduce)

Question 10

Verapamil, Diltiazem

Answer 10

Ca channel blocker; mainly for dysrhythmias; non-DHP: blocks Ca channels in vascular smooth muscle and myocardium –> dilation and decreased contractility (neg inotropic); peripheral edema; constipation

Question 11

Hydralazine

Answer 11

Vasodilator; for emergencies and AA pop; acts directly on arteries –> vasodilation (decreased afterload); lupus-like sx; reflex tachy (can add on beta blocker to reduce)

Question 12

Minoxidil

Answer 12

Vasodilator; Rogaine

Question 13

Nitroprusside

Answer 13

Vasodilator; for emergencies; acts directly on veins and arteries –> vasodilation (decreased preload and afterload); cyanide toxicity

Question 14

Hydrochlorthiazide

Answer 14

Thiazide (diuretic); prevents Na, Mg, K, Cl resorption (promotes elimination); depletion of Na, Mg, K, Cl; accumulation of glucose, lipids, uric acid, Ca; dehydration

Question 15

Tx guidelines for non-black pop

Answer 15

Thiazides, Ca channel blockers, ACE inhibitors/ARBs

Question 16

Tx guidelines for black pop

Answer 16

Thiazides, Ca channel blockers

Question 17

Tx guidelines for CKD pop

Answer 17

ACE inhibitors/ARBs

Question 18

HTN patho

Answer 18

SNS dysfunction (Na retention, insulin resistance, baroreceptor dysfunction/stretching); RAAS overactivity